DR. Damita Dora Wiredja, DDA
NPI #1740949056 in Maywood, California
Provider Information
- NPI Number
- 1740949056
- Entity Type
- Individual
- Name
- DR. Damita Dora Wiredja, DDA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DDA
- Enumeration Date
- Dec 14, 2021
- Last Updated
- Jan 5, 2022
Practice Location
- Address
- 6100 ATLANTIC BLVD STE I
- City
- Maywood
- State
- California
- ZIP Code
- 90270-3184
- Phone
- (323) 771-7551
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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